What is Cleft Lip and Cleft Palate?

It’s typical to a view cleft condition as something that “went wrong.” However, it’s more accurate to view it as something “unfinished.” Cleft lip, cleft palate (or any combination of the two) result from incomplete joining (fusion) of some embryo body areas, very early in baby’s development. This “failure to fuse” typically occurs during the sixth to 11th week of pregnancy. After a couple of windows of opportunity (one for the lip, the other for the palate), those particular sections of the body have no further chance to fuse. The body moves on to other development and the area of unfinished fusion becomes the basis for a cleft.

A fully-formed mouth and oral region allows breathing and eating to occur without confusing the two: an intact palate enables chewing without food going up the nose. Further, because the mouth is connected to the ear’s balancing and draining mechanisms, an intact palate helps ensure the critical inner ear muscles are properly connected to the inner ear mechanics. These connections allow the ear’s tiny Eustachian tube to sit at the proper angle, providing drainage and airflow. As the outlet for speech, the mouth and tongue rely on an intact palate to provide proper breath control and articulation required to create sounds. Incomplete closure of the lip, dental ridge (alveolus), and/or hard and soft palates cause a baby with a cleft lip/palate condition to face challenges in performing some of the most basic newborn tasks. 

Causes of Cleft?

Statistics reassure us that having a child with a cleft does not mean you’ll have other children with the same condition. In fact, your chances only increase by two to five percent compared to couples with no cleft-affected kids. Variations in the programmed information packets (genes) that determine a baby’s development enable clefts to occur in either gender and any race. It tends to affect boys more often than girls; and is slightly more common in some races as compared to others. While cleft lip/palate conditions occur alone, we also see them as a subset of other craniofacial (cranio, skull; facial, face) conditions, such as Stickler’s and Loeys-Dietz syndromes. 

Studies point to external and/or controllable factors that might contribute to the risk of having a child with this condition. Mothers between the ages of 19 and 35 statistically have a lower incidence of conceiving a baby with a cleft, as do moms who practice preventive measures such as taking supplemental folic acid, and eating a healthy diet with adequate vitamins and minerals. Women can take steps to reduce risk by avoiding environmental factors that may contribute to the likelihood of conceiving a baby with a cleft, including: pesticides, cigarettes, lead, and all varieties of drugs—prescription drugs, over-the-counter medications, illegal drugs, anti-convulsant medications, alcohol and any form of nicotine.

You can determine your approximate risk of conceiving a child with a cleft condition by obtaining genetic counseling prior to conception. Genetic counselors are highly educated in understanding how your health and family medical history relate to having a baby with a cleft. It is becoming the norm, rather than the exception, for cleft palate treatment team referral to occur during pregnancy following ultra sound diagnosis, rather than after the child’s birth.

Cleft Lip and Palate Treatment.

Fortunately, cleft lip and cleft palate conditions can be repaired with surgical procedures. Our team will evaluate your child, then plan treatment to create excellent function, form and appearance of the entire oral-facial area. Because the cleft can cause anomalies and dysfunction in other components of the baby’s mouth, jaws and ears, our plan includes several kinds of repair, specialists for each area, and a time frame to fit the child’s natural developmental windows—without disrupting or altering the natural growth patterns.

Children with a cleft(s) typically require both surgical and orthodontic intervention, since the cleft area affects the shape of the dental arch, how the teeth come in, and how the child’s bite lines up. A child’s constant growth also means that the oral-facial structures go through ongoing change and maturation even while we plan and implement corrections. In order to successfully and permanently control the eventual look and function of the mouth, we time each procedure to align with the child’s natural facial and dental development stages—thus, the child grows with the treatment.

Specifically, we design your child’s treatment plan to coordinate with predictable stages of maturity during which we can most effectively intervene. After our team completes a thorough diagnostic exam of your child’s condition, we’ll explain how these stages apply to your child’s particular case; we’ll also provide an ongoing analysis of your child’s progress throughout each stage, making adjustments based on your child response to treatment. Your care involvement, supportive attitude and patience will go a long way toward the success of our work. In fact, your commitment is essential to our ability to obtain the best possible function and appearance for your child. 

Register to Access Cleft Lip and Palate Forum.